Benefits August 25, 2006

Health Plans Agree to Create Health Care Provider Database

August 25, 2006 (PLANSPONSOR.com) - Seven health plans have agreed to participate in an initiative to create a database of information on the performance of physicians and hospitals across the country.
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Care Focused Purchasing, Inc. (CFP), an employer industry coalition advocating the quality and efficiency of providers as the basis for purchasing health care benefits, has announced it has finalized contracts with the seven plans and will begin aggregating claims data, Business Insurance reports. The participating plans include Aetna Inc.; CIGNA Corp.; Fiserv Health; Humana Inc.; Preferred Care; Regence Blue Shield; and WellPoint Inc. (Anthem Blue Cross & Blue Shield).

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The initiative was introduced in 2003 by Mercer Human Resource Consulting, according to Business Insurance. Under the initiative, a database will be created to combine participating insurers’ data on claims for more than 18 million members, including claims data from the 50 participating self-insured employers that collectively provide coverage to more than two million employees and dependents.

Individual providers and facilities will be identified and measured in the database and reports will be delivered to the partner carriers in early 2007. The partner carriers will then use the information to develop tiered networks, share it with plan members or use it in strategies to improve provider performance.

Compliance August 24, 2006

Corzine Signs NJ Employer Health Insurance Reporting Measure

August 24, 2006 (PLANSPONSOR.com) - New Jersey state health officials will now release an annual report listing Garden State employers with at least 50 workers and/or dependents on state-sponsored health programs as provided for under a new bill.
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Governor Jon Corzine signed into law S. 539, which provides for the annual report to be issued September 1 starting this year by the state’s Department of Health and Senior Services, Business Insurance reported.

The workers and dependents covered by the new law are those either in the state Medicaid program or in FamilyCare, a state program for low-income families who lack employer insurance, according to the news report.

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While the New Jersey State AFL-CIO supported the measure, the National Federation of Independent Businesses (NFIB) and the New Jersey Business & Industry Association opposed it. The NFIB warned that it could lead to mandated health insurance. The New Jersey business group described the bill as “nothing more than an effort to harass businesses at a time when most are already struggling to keep up with skyrocketing health insurance costs.”

Colorado Governor Bill Owens in June vetoed a similar proposal (See CO Governor Vetoes Two Health Care Bills ), calling the bill “well intentioned.”

“Not only does this bill threaten existingColorado jobs by pressuring employers into potentially unaffordable expenditures, SB 227 also would put Colorado at a competitive disadvantage in terms of job creation,” Owens wrote in his veto message. “Companies would be hesitant to bring family sustaining jobs to Colorado if they knew the state was injecting itself so directly and publicly into their business decisions.”

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